Where is cancer located

What is cancer The term cancer encompasses many different diseases. They all have one thing in common: body cells change (degenerate) and then grow in an uncontrolled manner. This destroys the surrounding tissue. Cancer can spread throughout the body and form what are known as metastases. How does cancer develop? What are typical cancer symptoms? How is cancer treated? You can find out all of this here.

Definition: what is cancer?

Cancer means that body cells change in a malignant way. They grow uncontrollably and damage healthy tissue. The Cells keep dividing - and usually much faster than healthy body cells. This creates a tumor that continues to grow. Doctors speak of one in this case Neoplasia - i.e. a new tissue formation - or a tumor.

Neoplasms or tumors can be benign or malignant. Doctors also refer to this asbenign or malignant. Malicious means that the tissue is growing very aggressively. The Malignant tumor grows in surrounding body structuresa and destroy them. Only malignant tumors are called cancer.

In some types of cancer, there is no typical malignant tumor from tissue cells. An example of this is blood cancer (leukemia). The diseased cells are here in the blood.

What are metastases?

Metastases are daughter tumors of a tumor. This means that the cancer cells have detached themselves from the original cancer focus and are over Bloodstream or that lymphatic system migrated to a different part of the body. Doctors differentiate:

  • Hematogenous metastasis: The cancer cells spread through the blood vessels
  • Lymphogenic metastasis: The cancer cells spread through the lymphatic system

In some cases, doctors come across tumors that cannot be clearly identified; a major tumor is not known. The cancer cells are so changed that even specialists can no longer find the place of origin. Then they speak of the so-called CUP syndrome (English: Cancer of Unknown Primary; German: Cancer of unknown origin).

What types of cancer are there?

Cancer can occur in a wide variety of organs in the body. There he assumes different types of cells that degenerate. Doctors divide malignant tumors into categories, depending on which cell types proliferate:

  • carcinoma
  • sarcoma
  • Blastoma
  • Malignant blood diseases

At Carcinoma cells of the proliferateinternal and external organ surfaces, also called epithelium. This includes skin and mucous membrane cells, but also glandular tissue. Common cancers are breast cancer (breast cancer), colon cancer (colorectal cancer), prostate cancer, or skin cancer.

Sarcomas arise mainly from Connective or supporting tissue of the body. Sarcomas affect fat tissue, muscles, tendons or bones, but also vessels and nerve cells. Examples are osteosarcoma from bone cells or liposarcoma from adipose tissue.

Blastomas are malignant tumors that occur during the Tissue or organ development arise. They therefore often affect children, for example neuroblastoma or retinoblastoma. An adult blastoma is glioblastoma, a malignant brain tumor.

At malignant blood diseases degenerateBlood or blood forming cells. These include, above all, the various types of blood cancer, called leukemia, and lymph node cancer. Some medical professionals also use the term to describe diseases "Malignant hemoblastosis" together.

Cancer diseases from A to Z

What are the most common cancers?

The frequency of the different types of cancer varies greatly. There are also differences between men and women: some types of cancer affect one gender more often than the other.

The most common cancers in women

By far the most common type of cancer in women is breast cancer (malignant breast cancer). Almost a third of all cancers in women affect the breast tissue. The five most common types of cancer at present are:

Breast cancer is also responsible for most cancer deaths in women. Lung, colon and pancreatic cancer follow.

The most common cancers in men

Prostate cancer is the most common type of cancer in men. Almost a quarter of all male cancers affect the prostate. The currently most common cancers in men are:

Lung cancer is responsible for most of the deaths. Prostate, colon, pancreatic, liver and stomach cancers follow.

Causes and Risk Factors

Researchers around the world are working to find out the exact causes of cancer. What Is Known: There are many different risk factors that contribute to the development of cancer.

Some cancers have one genetic cause. The genome contains information that increases the likelihood that cells will degenerate and proliferate. The tendency to cancer is therefore hereditary.

It has a major impact on the risk of cancer lifestyle. Around every third cancer is caused by an unhealthy lifestyle. Also the environment can negatively affect the risk of cancer.

Known Risk factors for cancer are:

  • Smoking (also passive smoking)
  • Obesity
  • Alcohol consumption
  • Unhealthy diet (too much red meat, too little fiber)
  • Sedentary lifestyle
  • Environmental toxins (e.g. pesticides)
  • Radiation (X-rays, Radon radiation, UV rays)
  • Certain contagious infectious diseases (HPV, hepatitis B)
  • Hormone replacement therapies

The risk factors mentioned can do that Damage genetic material (DNA). Even so, DNA errors occur continuously during cell division. The cells' repair mechanisms usually remove these defects without any problems. In cancer, however, this often no longer works properly, for example because the repair genes themselves have been changed.

Genetic changes (Mutations) can also affect gene segments that control cell growth and division. If the repair mechanisms do not keep up or if they are also disrupted, then these processes can get out of control: The Cells divide unchecked. The mutations are passed on so that more and more degenerate cells proliferate - a cancerous tumor develops.

Cancer Symptoms: What Are The Signs Of Cancer?

Cancer is usually tricky: In the early stages, many patients have no or only unspecific symptoms. Even so, there are warning signs that you can use to identify cancer.

General cancer symptoms include the so-called B symptoms:

  • Heavy night sweats
  • Elevated temperature, fever
  • Unintended weight loss

General signs for cancer can also be:

  • Constant fatigue
  • Exhaustion
  • Drop in performance
  • Pain with no apparent cause
  • dizziness

Cancer symptoms of Central nervous system (Brain and spinal cord) are shown for example by:

  • Seizures
  • Visual disturbances
  • a headache
  • dizziness
  • Symptoms of paralysis, language and coordination disorders

Signs of cancer im Gastrointestinal tract are:

  • difficulties swallowing
  • Persistent belching and heartburn
  • Changes in bowel movements (e.g. blood in the stool)
  • Constant feeling of pressure or fullness, abdominal pain
  • Nausea and vomiting, loss of appetite

Cancer symptoms of respiratory tract and des Cardiovascular system:

  • Shortness of breath
  • Chronic or bloody cough
  • Constant urge to cough
  • Chronic hoarseness
  • Racing heart

Changes Reproductive organs and urinary tract can be:

  • Changes in the breast (e.g. breast lumps)
  • Postmenopausal bleeding or spotting between periods
  • Changes in the testicles
  • Blood in the seminal fluid
  • Blood in the urine, urination disorders

Cancer symptoms at the skin are for example:

  • Swelling, induration, tissue damage
  • Lumps on / under the skin, mucous membrane or in soft tissues (e.g. enlarged goiter)
  • Wounds that do not heal or heal poorly
  • Moles and warts (changes in size, shape, and color)
  • paleness

With many cancers the lymph nodes swell. Because cancer cells can settle there. There are large lymph node stations

  • around the ears
  • On neck
  • around the collarbone
  • on the (lateral) chest wall and under the armpit
  • in the bar

If you experience one or more of these symptoms, it is advisable to see a doctor. Please note: In most cases, however, it is not cancer, but another disease.

If you actually have cancer and you are already seeing a doctor with unspecific symptoms, he may be able to diagnose the cancer at an early stage. Then the chance is much greater that the disease can be treated well. With some cancers such as colon cancer or testicular cancer, the chances of recovery are particularly good if they are detected in good time.

Diagnosing cancer

For cancer treatment to be successful, it is important that the disease is detected as early as possible. There are various diagnostic options available to the doctor for this.

If a patient is suspected of having cancer, he will first ask him carefully (anamnese). He asks the patient questions:

  • complaints
  • Living conditions of the patient
  • Previous medical history
  • Medical history of the patient's family

This is followed by the physical examination (clinical examination). The doctor will look at the patient's body, feel it, listen to it, tap it and test the body functions such as reflexes. He looks for unusual changes that indicate cancer.

If cancer remains suspected after the physical exam, a series of tests will follow. They are especially important in diagnosing cancer imaging procedures. Which one is used depends, among other things, on where the doctor suspects the cancer. Be available:

In order to be able to better differentiate a tumor or metastasis from healthy tissue in the gray slice images of MRI and CT, doctors often use Contrast media. Depending on which tissue is to be examined, the patient has to swallow the contrast medium before the examination or it is given directly into the veins (intravenously).

The doctor can also treat cancerous tumorsreflection see. He inserts an endoscope - usually a flexible tube with a small camera and a light source - into the corresponding organ. The camera then delivers images from inside the body. Well-known examples are the gastrointestinal endoscopy, the bladder endoscopy, the biliary endoscopy (ERCP) or the lung endoscopy.

The tissue sample is especially important in cancer diagnosis and assessment, too biopsy called. If the doctor finds abnormal tissue during the examination, he will take small pieces of it and have a pathologist examine it under the microscope in the laboratory. In this way, doctors can identify the exact type of cancer involved. Therapy is based on this.

If a malignant tumor grows in the body, certain substances are often to be found in the blood - the so-called Tumor markers. They are either produced by the tumor itself or arise because the tumor stimulates their production. As a rule, they are less used to diagnose cancer. Rather, doctors can use it to control the course of the disease. For example, doctors use tumor markers to estimate whether a therapy is working or not.

Blood tests on the other hand, are crucial in the case of malignant blood diseases. Atypically high, but also very low blood cell values ​​(especially red and white blood cells and platelets) are suspect here. Doctors can also obtain further information through a Bone marrow puncture.

Staging: extent of cancer

If it is certain that cancer is present, doctors classify the tumor according to international criteria. This is necessary for the selection of a suitable therapy. An initial prognosis can also be made from it.

When doctors want to assess the extent of cancer, they use (Staging) usually the TNM classification and the UICC stages.

TNM classification

The so-called TNM classification names the size and spread of the cancer in the body. Doctors divide cancer into three categories:

  • T: Size and spread of the tumor tumor)
  • N: Absence or presence of lymph node metastases node)
  • M.: Appearance of daughter tumors metastasis)

The information behind the letters provides information about the more precise expression. Every cancer has its own TNM system. In simple terms:

  • Tcis, T1-4 specifies the extent of the tumor (cis = carcinoma in situ, very early stage without invasive growth; 1 = small; 4 = large)
  • N0-3 indicates whether and how many lymph nodes are affected by cancer (0 = no lymph nodes are affected; 1-3 = increasing involvement of lymph nodes)
  • M0-1 states whether or not there are metastases (0 = no metastases; 1 = there are metastases)

Sometimes doctors add additional letters to the TNM classification. This enables them to collect even more information about cancer:

  • L.: Invasion of lymphatic vessels
  • V: Invasion of veins
  • Pn: Infection of nerve fibers (perineural invasion)

There is also further information: Letters in front of the TNM letters show, for example, how the TNM classification came about, for example p for a pathological staging based on the tissue examinations.

UICC stages

The Union internationale contre le cancer (UICC) divides cancer tumors into certain stages of development. The TNM information serves primarily as a basis. Every cancer has its own UICC classification.

  • Stage 0: Tumors without spreading into the connective tissue, without lymph node involvement and metastases
  • Stage 1: Small and medium-sized tumors (T1, T2) without lymph node involvement and metastases
  • Stage 2: Medium to large tumors (T3, T4) without lymph node involvement and metastases
  • Stage 3: Tumors of any size with metastases in 1-4 lymph nodes in the area without distant metastases
  • Stage 4: Tumors of any size with metastases in 1-4 lymph nodes in the area with distant metastases

Grading: the nature of the tumor tissue

If the doctor has removed tumor tissue, it is then examined under a microscope. Specialized doctors, the pathologists, determine the nature of the tissue and how much it differs from the healthy original tissue. So you rate theDegree of differentiation, also Grading called.

If the degenerate cells resemble the original tissue, doctors speak of good differentiation. If, on the other hand, the cells have changed very significantly and can hardly be assigned, they are poorly differentiated. Cancer tumors from little changed cells usually have a better prognosis than poorly differentiated growths. Doctors usually differentiate between four levels:

  • G1: well differentiated, high agreement with healthy tissue
  • G2: moderately differentiated
  • G3: poorly differentiated
  • G4: not differentiated; the tumor can no longer be assigned to a specific starting tissue

Stages in malignant blood diseases

The TNM classification and UICC stages are used to classify solid tumors such as lung cancer or colon cancer. There are separate classification systems for malignant blood diseases. Well-known examples are:

  • Ann Arbor stadiums for most types of lymph gland cancers
  • WHO and Fab criteria for acute leukemia
  • Binet classification in chronic lymphocytic leukemia
  • The Revised International Staging System (R-ISS) in multiple myeloma (plasmacytoma)

Cancer treatment

The therapy of a malignant tumor disease always depends on the type of cancer, its location and spread. Doctors also take into account the patient's age and general health. Whenever possible, the goal of cancer treatment is to cure the person. Doctors speak of curative therapy.

The main treatment options are:

  • surgery: A surgeon removes the cancerous tissue and tries to preserve as much healthy tissue as possible.
  • radiotherapy: The irradiation takes place from the outside (external) or by means of radioactive material from the inside (internal). Radiation therapy damages the tumor cells and their genetic makeup. This is how they die.
  • chemotherapy: Doctors give special drugs (cytostatics) against the cancer. They mainly act on rapidly dividing cells - just like tumor cells. When doctors try to cure, they often combine surgery with chemotherapy:
    • Neoadjuvant chemotherapy in front a surgical procedure aimed at reducing the size of the cancer focus
    • Adjuvant chemotherapy to a surgical procedure with the aim of killing any remaining cancer cells and thus preventing a relapse (relapse)
  • Bone marrow or stem cell therapy: The patient receives healthy stem cells. The method is used in particular for leukemia, but also for sarcomas or germ cell tumors. Normal blood cells then develop again from the healthy stem cells. Doctors differentiate:
    • Autologous stem cell transplant: The cells come from the person concerned
    • Allogeneic stem cell transplant: The stem cells come from a suitable donor
  • Targeted Therapy: Doctors give drugs that target properties that only the respective tumor cells have. The degenerate cells die, healthy cells are preserved.
  • Immunotherapy: This treatment affects defense mechanisms. Special drugs prevent the cancer from hiding from the immune system and, to a certain extent, also stimulate it so that it takes action against the cancer cells.
  • CAR T cell therapy: This method is quite a new form of cancer immunotherapy. Only selected clinics use them. Certain defense cells, the T cells, are taken from the patient and genetically modified so that they are directed against certain surface structures of the cancer cells. The doctors give the adjusted T cells back to the patient as an infusion. Ideally, the immune cells then multiply in the body and attack the cancer.
  • Hormone therapy: Doctors use them primarily for gender-specific cancers, such as prostate cancer or breast cancer. The agents inhibit the hormone-controlled growth of cancer cells.
  • Pain management: Cancer causes pain. Often only drugs such as non-steroidal anti-inflammatory drugs (NSAIDs, e.g. ibuprofen) and opiates can help. Sometimes cold or heat applications also alleviate the symptoms. Further information on pain therapy can be found on the Topic page pain.

Palliative therapy

Unfortunately, not every cancer is curable, for example when it is advanced and metastatic. Even in severely weakened or seriously ill patients, the cancer cure is often no longer achievable. Then doctors recommend one palliative therapy. In doing so, they try to curb the further growth of cancer. In addition, they do everything in their power to alleviate the patient's physical, psychological and social complaints as best as possible.

At least at the beginning of palliative therapy, treatments that are often used are similar to those used in a curative approach, such as palliative chemotherapy. However, if the death of the patient is foreseeable, medical professionals focus on measures that alleviate stressful symptoms such as pain or shortness of breath.

Supportive measures in the fight against cancer

The cancer itself, but also the cancer treatment, usually cause many different complaints. Supportive therapeutic measures help against this. They prevent these complaints or alleviate them if necessary. These include, for example:

  • Medicationfor the treatment of nausea, vomiting, diarrhea and skin changes caused by cancer therapy, or to protect the body from certain infections, which has been weakened by the disease / treatment.
  • Manual lymphatic drainage and physiotherapy, for example if lymphedema occurs after the operation.
  • Transfusionsif the body does not produce enough blood cells as a result of the illness or therapy. Then certain growth factors can sometimes help to stimulate blood formation.
  • Creams and special skin care products, for example against skin inflammation during irradiation
  • Mouthwash solutions, for example if the oral mucosa is dry or inflamed.

Chemotherapy, radiation therapy or immunotherapy are not possible without these supportive therapeutic measures.

Complementary & alternative methods

In some places so-called "holistic" or "biological" methods such as cancer diets or vitamin cures are offered as alternatives to conventional medicine. However, the effectiveness of these alternative methods - for example mistletoe, vitamin or mineral therapies - is so far not scientifically proven.

They can even harm the patient: namely, if he forego the effective therapies of conventional medicine, which have been proven by numerous studies, in their favor. Therefore, alternative means are ideally suited as a supportive measure. However, always discuss the application beforehand with your doctor. In this way you can avoid dangerous interactions with conventional treatment methods.

Rehabilitation after cancer treatment

Cancer and its treatment require a lot of strength. Cancer patients often find it difficult to return to everyday life after a successful fight. Here one can oncological rehabilitation help. The rehabilitation measures include nutritional advice, physiotherapy and various sports activities. The doctors in the rehabilitation clinic also keep an eye on the success of the therapy and counteract possible long-term effects of the treatment.

Diet in cancer

Loss of appetite, changes in taste, difficulty swallowing, inflammation of the lining of the mouth, nausea and vomiting, digestive problems and pain - all these side effects of cancer and its treatment interfere with the normal food intake of many patients. But this is particularly important with cancer. Because a cancer eats away at the body and the rapidly dividing cells take away a lot of energy. Cancer is a "consuming" disease.

A There are no special dietary recommendations for all cancer patients. Which nutrients and in which quantity a person concerned actually needs depends to a large extent on him individual location from.

As for healthy patients, the general dietary recommendations apply in many cases of cancer:

  • High fiber diet
  • Little sugar and salt
  • No overly fatty foods
  • Lots of vegetables, fruits and whole grains
  • If possible, no industrially processed foods
  • No (or hardly any) alcohol
  • Pay attention to weight and daily exercise

These recommendations may have to be adjusted depending on the disease and weight progression. Even if doctors have removed the stomach or pancreas during the course of treatment, separate dietary guidelines apply.

Malnutrition in cancer

Many cancer patients lose weight significantly as the disease progresses. This process often begins long before the disease is diagnosed. Therefore, the nutritional status of the patient should be recorded immediately after the cancer diagnosis. The German Society for Nutritional Medicine (DGEM) offers one on its website questionnaireto assess the nutritional situation.

When cancer patients lose weight, lose their appetite, and eat less, they are at risk of one Malnutrition. Doctors also speak of tumor cachexia or anorexia-cachexia syndrome. If one of the following criteria applies, there is malnutrition:

  • BMI <18.5 kg / m2
  • Accidental weight loss of more than 10-15% within 6 months
  • BMI <20 kg / m2 and accidental weight loss> 5% in the past 3 to 6 months

But be careful: sometimes the cancer causes water to accumulate, for example Ascites. Then the BMI is no longer meaningful. The accumulated fluid can simulate a normal weight.

If possible, the energy and nutrient requirements should always be covered by normal food intake. First and foremost, it is less important which foods the patient consumes, but rather that the energy and nutrient requirements are met. If there is a deficit that the patient cannot make up through diet, a qualified nutritionist can, in consultation with the doctors fortified foods recommend.

If the person concerned cannot compensate for the deficits through eating, the doctor can give him specially fortified Drinking meals administer. They contain a lot of energy and all the necessary nutrients. The last option is one artificial nutrition.

Prevention: How can you prevent cancer?

Cancer prevention is there to identify and treat diseases or their precursors at an early stage. That is why it is advisable to use the Medical checkups